International Team Science in Practice

CGH 16 January 2013

Oral Cytology Global Cytology [OCGN]

Introduction to the Oral Cytology Global Network (25 min.)

• Introduction of the OCGN team Ravi Mehrotra

• Oral Cancer in Developing Countries with need for Standardization of Cytology Ravi Mehrotra

• Challenges and present situation Mark Lingen

• African situation and liquid based cytology Jos Hille

• European perspective and Biomarkers Felix Koch

• US perspective and importance of cutting edge research Joel Epstein

• International Team Science in Practice Rubayi

Srivastava

Introduction to NCI Center for Global Health (15 min.)

• Sivaram Sudha, Office of Science Planning and Assessment Staff (OSPA), NIH/NCI Sivaram Sudha

• Bhadrasain Vikram, Radiation Research Program (RRP), NIH/NCI Bhadrasain

Vikram

• Preetha Rajaraman, Division of Cancer Epidimiology & Genetics, NIH/NCI Preetha

Rajaraman

Open Discussion (20 min.) All

Way Ahead and Future Plans (5 min.)Sudha Sivaram

Actions Required and Time frame (5 min.) Ravi Mehrotra

Agenda - OCGN at NCI Center for Global Health RM

Oral Cytology Global Network [OCGN]

Joel Epstein, DMD, MSD, FRCD(C), FDS RCS (Edin)Director, Oral MedicineDiv. of Otolaryngology & Head and Neck Surgery City of Hope, Duarte, California Jos Hille, DDS, MDent, FC Path (SA)Chief Pathologist/Head of Discipline and Professor in PathologyAmir Afrogheh, DDS, M.Ch.DDepartment of Oral & Maxillofacial PathologyUniversity of the Western Cape &National Health Laboratory Services at Tygerberg HospitalCape Town, South Africa

Felix P. Koch, MD, DMD, MBA, PhDOral & Maxillofacial Surgery-Plastic SurgeryUniversity Medical Centre, Johannes Gutenberg UniversityMainz, Germany

Mark W. Lingen, DDS, PhD, FRCPath (co-PI)Department of PathologyHuman Tissue Resource Center (HRTC)Editor-in-Chief, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyThe University of Chicago

CURRENT COLLABORATORS

Ravi Mehrotra, MD, PhD, MIAC, FRCPath (co-PI)DirectorInstitute of Cytology and Preventive Oncology (ICPO)Uttar Pradesh, India

Shaji Thomas, MDSDepartment of Oral & Maxillofacial SurgeryPreeti P. Nair, MDSDepartment of Oral MedicinePeople’s College of Dental Sciences & Research CenterBhopal, India C.S. Pramesh, M.S. FRCSThoracic SurgeryDepartment of Surgical OncologyTata Memorial Centre Devendra Chaukar, M.S.Head and Neck SurgeryDepartment of Surgical OncologyTata Memorial Centre Harshal ShahClinical InformaticsPersistent Systems, Ltd. Pune, India

RM

Oral Cytology Global Network [OCGN] NETWORK MAP

RM

Oral Cytology Global Network [OCGN]

To develop a clinical trial for the Oral Cytology Global Network (OCGN) focusing on early diagnosis of potentially malignant /high risk oral mucosal lesions (WHO definition: SIN III) and malignant lesions, including:

• the establishment of the research team; • the development of tools for data management and oversight of the

research; the development of a trial design and other essential elements of

the study, such as the protocol, recruitment strategies, and procedure

manuals; and• to collect feasibility data.

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CONCEPT

RM

International Team Science

• A Cyclical System of Learning and Application

• OCGN was conceived with a focus on team science.

• Program management from OHSL included a mixture of knowledge mining, network, and resource management.

• Leveraged information and communication technology to address the key questions in oral cytology.

• Used partner contributions to shape the agenda and the desired goals.

• Encourages collaboration between complimentary interest areas in Oral Cytology.

Collaboration and Execution

To develop a clinical trial for the Oral Cytology Global Network (OCGN) focusing on early diagnosis of oral cancer, including:

• the establishment of the research team; the development of tools for data management and oversight of the research

• the development of a trial design and other essential elements of the study, such as the protocol, recruitment strategies, and procedure manuals

• and to collect feasibility data.

OCGN AIM

CHALLENGES AND PRESENT SITUATION

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Oral Cytology Global Network [OCGN]

• Jos Hille African Situation and Liquid Based Cytology

• Joel Epstein US Perspective and Importance of Cutting Edge Research

• Felix Koch on European Perspective

REGIONAL PERSPECTIVES

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Oral Cytology Global Network [OCGN]

o Department of Craniomaxillofacial and reconstructive Surgery, University Medical School Mainz, Germany.

o The hospital hosts all medical specialities and a capacity of 800 beds. Our department resects and reconstructs about 80 cancer patients per year, mainly oral but also maxillary or facial, including free flaps.

o We follow up the cancer patients over years by a weekly out patient clinic. So long term studies on recurring cancer is possible.

o The laboratory has a RealTimePCR, ELISA, WesternBlot, Histology and Immunfluorescence microscopy facilities. Three technicians take care about the samples.

EUROPEAN PERSPECTIVE AND BIOMARKERS

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• Autofluorescence to find oral lesions, to define resection borders of oral carcinoma

• morphology based oral brush cytology to diagnose oral cancer• Biomarker added diagnosis by oral brush biopsy and mRNA gene

expression (Tenascin C, GSTM1, MMP2, CK17, Sox4, Bub3, Akt1, Rb1, GSTP1)

• Risk evaluation for oral cancer by genomic polymorphism on the basis of brush biopsy cells (GSTM1, CYP1a).

• Pognosis of oral cancer and susceptibility to chemotherapy or radiation treatment by genomic polymorphism (detoxification enzymes like GSTM1)

Oral Cytology Global Network [OCGN]RESEARCH FOCUS

FK

In Germany the early diagnosis of cancer is an important topic for general dentists. Tey are interested in…

• risk evaluation: how often should a patient be seen, especially if he has oral deseases like lichen planus or is a smoker. So the polymorphism screening by taking a brush biopsy could help.

• minimalinvasive technique to get a diagnosis in lesions, thatdo not seem to be oral cancer by visual examination (class II-Lesions)

Oral Cytology Global Network [OCGN]ORAL CANCER PREVENTION IN GERMANY

FK

Oral Cytology Global Network [OCGN]

- Cytology to get a multidimensional view on oral cells, gained by oral brush biopsies:

a. risk information about specific lesions for screening routineb. achieve a precise diagnosisc. informations, how to treat these lesions knowing the prognosis by

polymorphism.

However, if we as well intend to include genetic informations, the ethnic background as well as the habits should be distinguished to test the biomarkers, that suite the specific patinet.

Therefore our international group is a great opportunity to gain reliable research results, also including ethnic and behavourial aspects.

PERSPECTIVE

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Oral Cytology Global Network [OCGN]OVERALL WORKFLOW

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Oral Cytology Global Network [OCGN]INSTITUTIONAL WORKFLOW

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Oral Cytology Global Network [OCGN]BIOINFORMATICSHarshal Shah, Persistent Systems Limited.

HS/FK

OCGN Network DevelopmentTEAM DEVELOPMENT

RS

“Research Networking Systems (RNS) are systems which support individual researchers’ efforts to form and maintain optimal collaborative relationships for conducting productive research within a specific context.” 1

OHSL is a Research Networking System (RNS) 1

1Schleyer T, Butler B, Song M, Spallek H. The dawn of research networking: A proposed research agenda. Presented at: Second Annual VIVO National Conference; 2010 Aug 24-26; Washington, DC.

Our projects are collaborative across sectors and boundaries, and managed at the micro-level for research and evaluation. Scientist networks are captured, as are the processes and the collective knowledge accrued on the projects.

Information aggregation and synthesis from

multiple sources

integration with user’s workflow

research networking system

interoperability

DEFINITION

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OCGN Network DevelopmentTEAM SCIENCE PROJECT MANAGEMENT

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Oral Cytology Global Network [OCGN]

NIH Grant Applications:o NIDCR Clinical Trial or Biomarker Clinical Evaluation Study Planning Grant (R34)o Clinical Trial Implementation Cooperative Agreement (U01)

Prospective Outcomes:o Collective capacity built by consolidation of local resourceso Increased scientific knowledge and capacity in Individual institutions in four

continentso Low-cost instrument testing for early detection and preventiono Comparable international data across urban and rural boundaries for researcho Model for skills transfer: looking at the various aspects of how to most

effectively transfer the skill-sets along and efficient technical transferability to health care workers.

o Development of international collaborative model for early detection and prevention testing for other oral cancers.

PLANNING AND DELIVERY

ML/RM

OHSL

OPEN source of knowledge

Pertaining to HEALTH

Information SYSTEMS as

a tool

LABORATORY for people to drive in their innovations and ideas

Thank You!

Joseph L. Badaracco, John Shad Professor of Business Ethics at Harvard Business School

In today’s environment, hoarding knowledge ultimately erodes your power. If you know something very important, the way to get power is by actually sharing it.

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Contact Info:Rubayi Srivastava, PPP Project Manager, California

Open Health Systems Laboratory@ Johns Hopkins Montgomery County Campus

9601 Medical Center DriveRockville, MD 20850, USA

+ 001 301 760 4014 office+001 408 410 1109 mobile

Rubayi.srivastava@ohsl.us

www.ohsl.us